Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

Flaxseed may reduce blood pressure, early findings show

Nov 01, 2013 Viewed: 1600

Eating a bit of flaxseed each day might help lower high blood pressure, a new study suggests.

Researchers said it’s too early to swap out blood pressure medication for the fiber-filled seeds just yet. But if future studies confirm the new results, flax might be a cheap way to treat high blood pressure, they added.

Flaxseed is well known as a plant source of omega-3 fatty acids, fiber and lignans, a type of antioxidants.

But so far, its effect on high blood pressure, or hypertension, has been better studied among animals than humans.

“This is the first demonstration of the cardiovascular effects of dietary flaxseed in a hypertensive population,” Grant Pierce told Reuters Health in an email. Pierce is the senior author on the study and executive director of research at St. Boniface Hospital in Winnipeg, Manitoba, Canada.

One in three American adults has high blood pressure, considered 140/90 millimeters of mercury (mm Hg) and over, according to the National Institutes of Health.

Having high blood pressure increases a person’s risk of heart disease and stroke. The condition costs the U.S. billions of dollars each year, Pierce said.

“It is the number one reason for a person to visit a physician in the U.S. today,” he said. “Understanding how to reduce blood pressure has become, therefore, a critical challenge.”

His team’s results were published in the journal Hypertension.

The trial included 110 people who had been diagnosed with peripheral artery disease, in which plaque builds up in arteries in the leg. Patients with the condition often have high blood pressure.

The participants were randomly assigned to either a flaxseed or comparison group.

People in the flaxseed group ate a variety of foods like bagels, muffins and pasta that contained 30 grams - about one ounce - of milled flaxseed every day for six months.

Those in the comparison group were given foods that tasted similar, but didn’t contain any flaxseed.

The researchers had participants increase their dose of flaxseed gradually so they could become accustomed to the fiber load.

Still, one in five participants dropped out of each group during the trial. Some of that could have been due to stomach pain from the extra fiber, Pierce said.

People who had an initial systolic blood pressure - the top number in a blood pressure reading - of at least 140 mm Hg saw that figure drop by 15 mm Hg, on average, after six months of taking flaxseed.

Their diastolic blood pressure - the bottom number - also fell by 7 mm Hg. Blood pressure did not change among people with hypertension in the comparison group.

“These decreases in (blood pressure) are amongst the most potent dietary interventions observed and comparable to current medications,” Pierce said.

There was no flaxseed-related benefit for people with normal blood pressure, however.

Flaxseed costs about 25 to 50 cents per ounce.

The new study was partially funded by the Flax Council of Canada. It wasn’t originally designed to study blood pressure, which means the results have to be interpreted with more caution.

“The study results are indeed surprising - it is actually hard to imagine such huge reductions in blood pressure with flax seed mixed in food stuffs,” Dr. William B. White told Reuters Health in an email.

White, from the University of Connecticut School of Medicine in Farmington, is also the president of the American Society of Hypertension. He was not involved in the new study.

He also expressed some concern that measuring blood pressure changes was not the initial reason for doing the study. And he said the way blood pressure was measured - during a single office visit - isn’t as accurate as checking it at multiple points throughout the day.

“The results are preliminary - there is not enough information to justify people taking flax seed for the control of hypertension. A larger, more controlled trial with out-of-office blood pressure would be needed,” White said.

Flaxseed contains ω-3 fatty acids, lignans, and fiber that together may provide benefits to patients with cardiovascular disease. Animal work identified that patients with peripheral artery disease may particularly benefit from dietary supplementation with flaxseed. Hypertension is commonly associated with peripheral artery disease. The purpose of the study was to examine the effects of daily ingestion of flaxseed on ystolic (SBP) and diastolic blood pressure (DBP) in peripheral artery disease patients. In this prospective, double-blinded, placebo-controlled, randomized trial, patients (110 in total) ingested a variety of foods that contained 30 g of milled flaxseed or placebo each day over 6 months. Plasma levels of the ω-3 fatty acid α-linolenic acid and enterolignans increased 2- to 50-fold in the flaxseed-fed group but did not increase significantly in the placebo group. Patient body weights were not significantly different between the 2 groups at any time. SBP was ≈10 mm Hg lower, and DBP was ≈7 mm Hg lower in the flaxseed group compared with placebo after 6 months. Patients who entered the trial with a SBP ≥140 mm Hg at baseline obtained a significant reduction of 15 mm Hg in SBP and 7 mm Hg in DBP from flaxseed ingestion. The antihypertensive effect was achieved selectively in hypertensive patients. Circulating α-linolenic acid levels correlated with SBP and DBP, and lignan levels correlated with changes in DBP. In summary, flaxseed induced one of the most potent antihypertensive effects achieved by a dietary intervention.

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